healthcare, law

Do you go to bloggers for advice about life and death decisions? I don’t.

Many thanks to a reader who contacted me on Facebook this morning. This person probably spared you all another rant on a topic I’ve already covered. I was considering writing about Delta Airlines’ proposal for all U.S. based airlines to share their “no fly” lists. But then I got this message, and I must admit, it left me scratching my head.

The commenter evidently didn’t want to leave a response on the blog itself. They found my official OH Facebook page and decided to leave me a somewhat well-written and, at least on the surface, reasonable response to a post I recently wrote about COVID-19. They wrote I shouldn’t be writing such “strong opinions” against the use of Ivermectin in the treatment against COVID-19, reminding me that I have a “public” audience who might be negatively affected by my comments. They reminded me that no one should claim any “definitive knowledge as yet”– I’m assuming about COVID-19– and implied that my opinion lacks a “rational basis”.

I don’t know a thing about this commenter, nor does s/he know much about me. Based on what I could see on Statcounter, this person with a very bare Facebook profile, comes from Las Vegas and read two posts over the course of about three minutes. He or she probably doesn’t know that I have a master’s degree in public health. Perhaps he or she would not be “impressed” by that. In any case, earlier in the comment, the person “informed” me that sometimes physicians prescribe drugs off-label. That’s not news to me, and in fact, I even mentioned that in the post I’m assuming was referenced in the message. That post was mostly my positive opinion about Judge Charles Cunningham of Louisville, Kentucky, who recently ruled that the wife of a COVID-19 patient could not compel hospital doctors to prescribe Ivermectin off-label to treat COVID-19.

I write that “I’m assuming”, because the commenter didn’t specifically reference a blog post in their message. Regular readers might remember that I recently took down my generic “contact” page, because I kept getting comments from people who didn’t specify the posts to which they were referencing. Statcounter is a pretty good tool, but not everyone who visits my blog shows up on it. If there isn’t an IP trail on Statcounter, and the specific post isn’t mentioned, I’m sometimes left wondering which post to address. It wasn’t the first time I got a comment with no reference, so I determined that the contact page wasn’t helpful and removed it. And now, I’m thinking the Facebook page probably isn’t helpful, either, since I’ve run into the same issue this morning.

Anyway, this person who wrote to me evidently thinks that patients or their loved ones should be able to go to court to demand that legal experts force medical experts to prescribe medications for off-label use. And the person subtly chastised me for disagreeing with that idea by posting a strongly worded opinion piece on my blog. Then, at the end of their message, they wrote this:

NO ONE should claim any definitive knowledge as yet – which defaults to each of us knows what is in our own best interests. And in a life or death situation, anyone who interferes ought to be imprisoned, or worse. Think about how you would feel if the situation were reversed, and perhaps you will avoid making such strong opinion calls, without a rational basis – you have a public audience. Who knows how much harm you could cause…. thank you…”

On the surface, I guess the above portion of the comment sounds reasonable enough. Most people would like to make their own decisions about “life or death situations”. But there’s a reason why people go to medical school to become physicians. There are good reasons why physicians must be trained and licensed before they can practice medicine and make treatment decisions for others.

I don’t go to lawyers or judges for medical treatment decisions. I go to competent healthcare professionals who have specific training and experience in treating medical issues. If I, as a competent adult, choose not to go to a healthcare professional and seek alternative care from someone else, that might be my decision and it might only harm me. Some people would probably think it unwise, but I suppose it would be my “right”. And if I had a disease that wasn’t contagious, maybe that would be okay, if ill-advised.

When it comes to COVID-19, I think we have to consider the impact one person’s decisions might have on another’s. COVID-19 is an extremely contagious and potentially deadly virus, and it seems to be getting more contagious with each new variant. There aren’t enough hospital beds to take care of all of the people who need them, to include people who have other medical problems besides COVID. Ivermectin is currently not approved by the Food and Drug Administration for treatment against COVID. Is it being studied by researchers? Probably… but at this point in time, Ivermectin is NOT currently supported by the medical community for use in treating COVID-19. That is a fact. I don’t know if Ivermectin ever will be named the key to conquering COVID-19, but at this point, it is still not recommended.

What I do know is that some people are taking it upon themselves to self-medicate with the drug. Most of them don’t know what they’re doing. Some of them are getting very sick and, no doubt, taking up hospital bed space needed by people who don’t routinely take drugs intended for veterinary use. So the fact that it’s being widely touted by certain groups as a “cure” or effective treatment is, in my view, irresponsible and potentially dangerous.

Moreover, even in the case of “off-label” use for drugs (and I once had a doctor who prescribed a drug for me for “off-label” reasons), there’s usually a consensus that the drug is useful for that purpose. At this point, I haven’t seen much support for Ivermectin to be used in that way by reputable medical professionals. I’ve only seen it touted by people who are pushing conspiracy theories.

Even if Ivermectin is a great drug for COVID-19, and I have not yet seen any compelling evidence that it is, it should certainly not be used by laypeople who have no experience with its use. People should not be going to their local feed and tack shop, buying up horse wormer to ward off COVID-19. That’s my opinion, of course. You can take that for whatever it’s worth.

As someone with a master’s degree in public health and actual work experience in epidemiology, I think I know how to research these things. However, I will admit that I don’t have all of the answers. I just know enough to find someone who knows more than I do and listen to what they have to say. I think that’s a pretty wise way to live life, but your mileage may vary. So far, it’s served me pretty well.

I do think it’s interesting that many people who wouldn’t get a COVID-19 vaccine because “it’s [wasn’t] FDA approved” (a situation that is changing) and “we don’t know the long-term effects of the vaccine”, are all into using Ivermectin off-label to treat COVID-19, which is definitely not FDA approved. We’ve seen some real and documented evidence by trusted entities that COVID vaccinated individuals are staying out of hospitals and not getting as sick as unvaccinated people are. Most of what I’ve read about Ivermectin treatment in COVID-19 cases is that people are overdosing on it and getting sick. I don’t know about you, but that makes me think that taking Ivermectin isn’t the smartest idea.

Moreover, an article by The Guardian from July 2021 reports that a “huge” study endorsing Ivermectin as a COVID-19 treatment was withdrawn over ethics concerns. I will admit that I haven’t looked for anything from September that refutes this article, which basically states that a lot of medical providers were defrauded, but I do know that July wasn’t long ago. And as a run-of-the-mill blogger, I’m not going to take the time to go poring through medical journals for an opinion based blog post that gets maybe 25 hits in a day.

The person who wrote to me this morning reminded me that hospital doctors must “toe” the “party line (and it’s “toe”, not “tow”) or they’ll get fired. The person also wrote that the “ban” against Ivermectin is “politically motivated.” As I mentioned up post, this person appeared to be writing me from Las Vegas, which means he or she is residing in the United States.

They might be interested in knowing that I live in Germany, where Ivermectin is also not recommended for treatment against COVID-19, outside of a clinical trial. So, if banning Ivermectin for COVID-19 use is “politically motivated” in the United States, am I to believe that the ban is also “politically motivated” in Europe? Because Germany is not the only European country that does not recommend the use of Ivermectin for treating the coronavirus. Here’s a link from March from the European Medicines Agency, which is as official in Europe as the CDC and the FDA are in the United States. Likewise, the World Health Organization also recommends that Ivermectin only be used in clinical trial settings

In other words, Ivermectin should probably NOT be used by any old physician who is throwing everything against the wall to see if something sticks. Who knows what the motivation is behind those physicians who are touting off-label use of Ivermectin? Perhaps they are politically and financially motivated. As a matter of fact, how do I know what my commenter’s motivations are for taking the time to write to me after having spent about three minutes reading two posts on this blog? Why does it even matter to that person what my opinions about Judge Cunningham and Ivermectin use in COVID cases are?

In any case, what I really want to address in today’s post is this person’s parting shot to me.

Think about how you would feel if the situation were reversed, and perhaps you will avoid making such strong opinion calls, without a rational basis – you have a public audience. Who knows how much harm you could cause…. thank you…

So basically, the commenter seems to think that because some people might somehow construe my opinions as “medical advice”, I shouldn’t express myself on a blog because I might unintentionally cause them “harm”. Or, at least that’s what I think I’m reading. And people who read my blog are not smart enough to think for themselves and are coming to me for advice on life and death issues. Right. Does this person think the same thing about people who express opinions on social media platforms?

This is a blog. It’s not even a very popular blog. On a good day, I crack about 200 hits. The vast majority of people who read this blog are total strangers to me. Anyone who goes to a blogger for medical advice, particularly when the name of the blog is “The Overeducated HOUSEWIFE” and not “The Overeducated Physician”, is not long on common sense. Why would any sane person go to a self-proclaimed housewife for medical advice? But I guess, since this person seems to think I have so much power because of my “public audience”, I’ll put up a legal disclaimer.

If you are seriously unwell and need medical assistance, I think you should seek the advice of a competent and licensed healthcare provider in your area. You should not go to a personal blog written by a total stranger for medical advice. I would hope that notion would be common sense, but now I realize that some people need to be explicitly told. So thanks to this morning’s commenter for that. I’ll make a note of it.

As always, I wish everyone who reads my blog continued good health and success in life. And please, if you are going to send me a Facebook private message on my OH page, do me a favor and reference the post to which you are referring. Or, even better, simply comment on the post itself. I usually provide links on the official OH page for those who don’t want to make a WordPress account.

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